CONTENTS
1. IFH/RSPH conference – abandoning the hygiene hypothesis
2. IFH e-learning resource - “A simple guide to living in a germy world”
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Conference Report
Abandoning the hygiene hypothesis – restoring public confidence in hygiene
On Feb 11th 2016 the IFH, in collaboration with the Royal Society of Public Health, hosted a conference at Portland Place, London. This unique event brought together experts in both allergic and infectious diseases including Dr Paul Turner (Imperial College London), Dr Rosalind Stanwell Smith (London School of Hygiene and Tropical Medicine), Professor Graham Rook (University College London), Professor Sally Bloomfield (London School of Hygiene and Tropical Medicine), Dr David Dowling (Harvard Medical School, Boston, USA), Professor Fergus Shanahan (University of Cork, Ireland) and Professor Elizabeth Scott (Simmons College, Boston, USA).
The aim was to review allergies and infectious diseases in light of the recent explosion of data on the human microbiome and its role in our health, and to evaluate strategies which might be adopted to tackle these issues – including how to refute the persistent idea that “being too clean” is a root cause of the rise in allergies, a concept which undermines attitudes to hygiene and its importance in controlling infectious diseases.
Speakers showed how interaction with the “Old Friends” microbes which inhabit the natural environment and our human microbiome play an essential role in immune regulation, and may be important in the development of immune tolerance towards allergens. They also reviewed the latest evidence showing how changes in lifestyle and environmental exposure along with rapid urbanisation, altered diet and excessive antibiotic use, have had profound effects on the human microbiome, leading to a failure of immune tolerance and increased risk of allergic disease.
The conference found that the public’s belief that we need exposure to infections, and that hygiene and cleanliness are a root cause of the rise in allergic disease, is no longer supported, Data show that relevant microbial exposures are almost entirely unrelated to hygiene as the public understands it.
Key findings of the conference for future strategies were:
- A combination of strategies including natural childbirth, breastfeeding, increased social exposure through sport and other outdoor activities, less time spent indoors, diet and appropriate antibiotic use, may help restore the microbiome and perhaps reduce the risks of allergic disease – however -
- Further work is required to establish whether and to what extent lifestyle changes may impact on levels of allergic diseases. Owing to the multiplicity of factors involved, strategies to preserve or manipulate the human microbiota may require a personalised approach tailored to individual genetics and lifestyle factors.
- The term “hygiene hypothesis” must be abandoned.
- Tackling the issues of infectious disease requires smarter approaches to hygiene. Promotion of a risk assessment approach to hygiene (targeted hygiene) provides a framework for maximising protection against pathogen exposure while allowing spread of essential microbes between family members.
- To build on these findings, we must change public, public health and professional perceptions about the microbiome and about hygiene. We need to restore public understanding of hygiene as a means to prevent infectious disease.
- In the future, we are going to have to view our microbial world very differently. Microbiome science is showing us that humans are ecosystems, where the microbes that live on and within us constitute an organ as essential to our health as our liver and kidneys.
These and other issues related to allergies, infectious diseases and hygiene will be reviewed further in an upcoming July special issue of the RSPH Journal Perspectives in Public Health entitled “the hygiene misnomer”.
NEW – IFH e-learning resource “A simple guide to living in a germy world”
IFH took the opportunity of the IFH/RSPH conference to release our new e-learning resource.
This is an interactive guide that explains our current understanding of how and why reduced interaction with our microbial world may be linked to rising levels of allergies and other chronic inflammatory diseases; it looks at current views about the lifestyle changes which may have altered or reduced our interaction with our microbial world in a manner which has caused immune dysregulation. At the same time, it also examines why the idea that hygiene and cleanliness are a root cause of the rise in allergic and other diseases is no longer supported.
The guide examines how we can develop hygiene habits that protect us against infectious diseases whilst at the same time maintaining exposure to the microbes which are important for our health. Every effort has been made to write this material in simple non-technical language, so that it can be understood by a multidisciplinary audience.
The resource can be downloaded from: http://www.ifh-homehygiene.org/online-learning-home-healthcare-hygiene-advice-sheet/simple-guide-healthy-living-germy-world-so
